TREATMENT OF PAIN DURING THE ACUTE CARE STAY FOR PATIENTS LIVING WITH DEMENTIA

Abstract The purpose of this study was to describe pain among hospitalized patients living with dementia, the use of pharmacologic and nonpharmacologic treatment, and to compare treatments among those with and without pain. Data from the first 365 participants in the FFC-AC-EIT study was used. The mean age of participants was 83 (SD=5), the majority was female (65%) and White (67%). Controlling for treatment, between admission to discharge there was a significant decrease in pain from 36% having pain on admission to 31% at discharge (F=5.30, p=.02). At discharge 125 (30%) had pain and 8 (6%) of individuals with pain received no nonpharmacological or pharmacological treatments during the hospital stay. The most frequently used pharmacological intervention was acetaminophen (52%), then tramadol (8%). Comfort measures (49%), physical activity (46%), and communication (38%) were the most common nonpharmacologic approaches. Between those with and without pain there was no difference in use of pharmacologic interventions (F = .38, p =.54) and there was less use of nonpharmacological treatments for those with pain (F=10.24, p=.002). The majority of patients living with dementia were treated for pain, but an ongoing focus is needed to assure optimal pain management for all patients. More attention to use of and evaluation of effectiveness of pharmacologic and nonpharmacologic treatments alone or together are needed for hospitalized patients living with dementia.

anticonvulsants, dementia drugs, antipsychotics, sedativehypnotics, and opioids) were obtained at baseline and medications were obtained as well at discharge.To compare change over time generalized estimating equations were used.The participants were mostly female (63%), White (69%), and 83.06 years (SD=7.90)old.There was no treatment effect.Antidepressant, antianxiety, anticonvulsant, dementia medication, sedative hypnotic and opioid use remained unchanged.Antipsychotic medication use increased significantly from 16% to 21% at discharge.Some changes were made across drug groups such as change from haloperidol to second generation antipsychotics to decrease risk of side effects.A more focused deprescribing intervention is needed to best address psychotropic medication use among individuals living with dementia when hospitalized.The aim of this study was to examine the impact of physical activity during hospitalization on behavioral and psychological symptoms of dementia among older adults, after controlling for covariates (age, gender, race, comorbidities, care interactions, and treatment group) and examine the association of physical and behavioral and psychological symptoms of dementia among hospitalized older adults living with dementia.Data from the first 365 participants in the FFC-AC-EIT study was used.Physical activity was measured over 24 hours and was based on the Physical Activity Survey which included the following activities: walking, wheeling, bathing, dressing, feeding, grooming, and toileting.Behavioral and psychological symptoms associated with dementia were based on the Neuropsychiatric Inventory (NPI).The mean age of participants was 83.18 years, the majority was female (63.6%) and White (69.4%), the mean NPI was 1.28(SD=1.85)and mean activities was 8(SD=5).A total of 16% of individuals performed no activity.The most common activity was eating and the least commonly performed was self-propelling in a wheelchair.A total of 40% engaged in walking and 60% performed some bathing and dressing while hospitalized.After controlling for covariates, physical activity explained an additional 2% of the variance in NPI scores (beta=-.13., p=.05).There was no evidence that engaging patients in physical activity resulted in behavioral symptoms and activity may help to decrease these symptoms.Continued focus is needed to engage older adults living with dementia when hospitalized to engage in routine physical activity by performing activities of daily living.

TREATMENT OF PAIN DURING THE ACUTE CARE STAY FOR PATIENTS LIVING WITH DEMENTIA Marie Boltz, Pennsylvania State University, State College, Pennsylvania, United States
The purpose of this study was to describe pain among hospitalized patients living with dementia, the use of pharmacologic and nonpharmacologic treatment, and to compare treatments among those with and without pain.Data from the first 365 participants in the FFC-AC-EIT study was used.
The mean age of participants was 83 (SD=5), the majority was female (65%) and White (67%).Controlling for treatment, between admission to discharge there was a significant decrease in pain from 36% having pain on admission to 31% at discharge (F=5.30,p=.02).At discharge 125 (30%) had pain and 8 (6%) of individuals with pain received no nonpharmacological or pharmacological treatments during the hospital stay.The most frequently used pharmacological intervention was acetaminophen (52%), then tramadol (8%).Comfort measures (49%), physical activity (46%), and communication (38%) were the most common nonpharmacologic approaches.Between those with and without pain there was no difference in use of pharmacologic interventions (F = .38,p =.54) and there was less use of nonpharmacological treatments for those with pain (F=10.24,p=.002).The majority of patients living with dementia were treated for pain, but an ongoing focus is needed to assure optimal pain management for all patients.More attention to use of and evaluation of effectiveness of pharmacologic and nonpharmacologic treatments alone or together are needed for hospitalized patients living with dementia.

FACTORS ASSOCIATED WITH PARTICIPATION IN FUNCTION-FOCUSED CARE AMONG HOSPITALIZED PATIENTS LIVING WITH DEMENTIA Ashley Kuzmik, Pennsylvania State University, State College, Pennsylvania, United States
Function focused care is an approach used to increase physical activity in hospitalized older adults living with dementia.This study tested the factors associated with participating in function focused care among patients living with dementia.This was a cross-sectional descriptive study using baseline data from the first 365 participants from the first 10 hospitals in the study entitled, Testing the Effectiveness of Function Focused Care for Acute Care Using the Evidence Integration Triangle.Structural equation modeling was used for model testing.The mean age of the participants was 83.2 (SD=8.0)and the majority were women (64%) and white (69%).Fifteen of the 27 hypothesized paths were significant and explained 25% of the variance in performance of function focused care.Cognition, quality of care interactions, behavioral and psychological symptoms associated with dementia, physical resilience, and pain were all indirectly associated with performance of function focused care through function and/or pain.Tethers, function, and quality of care interactions were all directly associated with function focused care.The x2 / df was 5.37, the normed fit index was .87 and the Root Mean Error Square of Approximation was .12.For hospitalized patients living with dementia the focus of care should be on treating pain and behavioral symptoms, decreasing tethers, and improving quality of care interactions so as to optimize resilience, function and participation in function focused care.

EMPOWERING LGBTQ OLDER ADULTS: PROMOTING HEALTH EQUITY AND WELL-BEING ACROSS THE LIFE COURSE
Chair: Hyun-Jun Kim Discussant: Karen Fredriksen-Goldsen The population is becoming more diverse in terms of sexual orientation and gender identity across all age groups.Lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults are found to experience health disadvantages over time.However, there is a lack of research on healthrelated mechanisms, so it is important to understand the unique needs and resources in these underserved communities.This symposium fills this research gap by examining the factors that affect LGBTQ health trajectories and subgroup differences using a life course developmental framework, the Health Equity Promotion Model (HEPM).The HEPM model highlights historical, social, environmental, and cultural influence on health and well-being and varying adaptations of LGBTQ older adults.The symposium draws on data from the first national and longitudinal study, Aging with Pride: National Health, Aging and Sexuality/Gender study, which has been following 2,450 LGBTQ midlife and older adults since 2014.Dr. Nelson will discuss sexual and gender identities and their associations with physical and psychological health-related quality of life.By investigating the interplay between marginalization, health behaviors, and health care access over time, Dr. Fredriksen-Goldsen assesses quality of life over time by gender and generational differences.Dr. Kim will discuss the role of social connectivity and intersectionality in predicting cognitive impairment over time among racially and ethnically diverse LGBTQ older adults.Using a health equity lens, this symposium will shed new light on the ways in which historical and environmental contexts influence human development and how marginalization and resilience shape lives over time.This is a Rainbow Research Group Interest Group Sponsored Symposium.

SEXUAL AND GENDER IDENTITY AND THEIR PROPERTIES IN AGING WITH PRIDE: NATIONAL HEALTH, AGING, AND SEXUALITY AND GENDER STUDY
Christi Nelson, Karen Fredriksen-Goldsen, Charles Hoy-Ellis, Meghan Romanelli, and Hyun-Jun Kim, University of Washington, Seattle, Washington, United States Increasing diversity and rapidly evolving sociopolitical context are changing how sexuality and gender identity are experienced, expressed, and measured in contemporary America.Based on longitudinal data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study, we examine sexual and gender identity, differentiation from other related constructs (i.e., desire, behavior, expression, relationships) as well as the associations between properties of sexual and gender identities (e.g., congruence, continua, visibility, centrality, and transformation) and the health and well-being of LGBTQ midlife and older adults (N=2,233), aged 50-102 at baseline.The findings document important differences in current as well as lifetime sexual experiences, desires, and romantic relationships by sexuality and gender identity.Measures incorporating a continuum as opposed to binary response categories better capture the experiences of bisexual, sexually diverse, and transgender older participants as compared to lesbians and gay men.When examining transformation, 7% reported changes to their sexual identity and 3% reported changes to their gender identity over 4 years.Those who changed their identity over time showed a